Ketamine for Analgosedation in the Intensive Care Unit: A Systematic Review

Asad E Patanwala, Jennifer R. Martin, Brian L Erstad

Research output: Contribution to journalReview article

17 Scopus citations

Abstract

Objective: To evaluate the evidence for the use of intravenous ketamine for analgosedation in the intensive care unit. Methods: MEDLINE and EMBASE were queried from inception until July 2015. Search terms used included ketamine, intensive care, and critical care. The search retrieved 584 articles to be screened for inclusion. The intent was to include randomized controlled studies using sustained intravenous infusions (>24 hours) of ketamine in the critically ill patients. Results: One trial evaluated opioid consumption as an outcome in postoperative critically ill patients who were randomized to ketamine or saline infusions. The mean cumulative morphine consumption at 48 hours was significantly lower in the ketamine group (58 ± 35 mg) compared to the morphine-only group (80 ± 37 mg; P <.05). Other trials showed the potential safety of ketamine in terms of cerebral hemodynamics in patients with traumatic brain injury, improved gastrointestinal motility, and decreased vasopressor requirements. The observational study and case reports suggest that ketamine is safe and effective and may have a role in patients who are refractory to other therapies. Conclusion: Ketamine use may decrease analgesic consumption in the intensive care unit. Additional trials are needed to further delineate the role of ketamine for analgosedation.

Original languageEnglish (US)
Pages (from-to)387-395
Number of pages9
JournalJournal of Intensive Care Medicine
Volume32
Issue number6
DOIs
StatePublished - Jul 1 2017

Keywords

  • analgesia
  • critical care
  • hypnotics and sedatives
  • intensive care
  • ketamine
  • pain

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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